Evaluating Long-Term Outcomes and Personalized Treatment Strategies in Advanced Gastrointestinal Cancers

Opinion
Video

Panelists discuss how the long-term follow-up data from CheckMate649 are crucial for understanding the durability of nivolumab plus chemotherapy’s benefit in first-line advanced gastric cancers (GCs)/gastroesophageal junction cancers (GEJCs). The survival outcomes help validate this regimen’s position as a standard of care, particularly for patients with PD-L1 combined positive score (CPS) ≥ 5. Although the magnitude of benefit varies by PD-L1 expression, both overall survival (OS) and progression-free survival (PFS) data inform personalized treatment decisions, with stronger evidence supporting immunotherapy use in higher PD-L1–expressing tumors while maintaining use across most patient subgroups.

  • Please comment on the significance of a 5-year update for CheckMate649.
  • How might this affect your current clinical practice?
  • How do the OS and PFS benefits at 5 years reinforce or challenge nivolumab plus chemotherapy as the standard first-line treatment for this patient population?
  • How might the OS benefit in subgroups, particularly those defined by PD-L1 CPS thresholds, guide personalized treatment strategies for advanced GC/GEJC/esophageal adenocarcinoma?
  • How might these results influence treatment decisions for patients with low vs high PD-L1 CPSs?
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